Optometrist Scope Expansion

Doctors of Optometry practice in more than 100 cities and towns across Alberta and provide the most broad-based, easily accessible and cost-effective vision care services in our province.

Our members are educated and clinically trained to provide skilled and competent care. They are committed to public safety, the preservation of sight and mitigation of vision loss for all Albertans.

The Alberta College of Optometrists is seeking a responsible expansion to the legislated optometry scope of practice.

The requested scope expansion includes authorization to perform minor laser treatments and superficial skin surgical procedures such as the removal of skin tags, warts and other surface lesions.

Quick Overview – Limited Laser and Superficial Skin Procedures

Limited Superficial Procedures
SLT
Peripheral Iridotomy
Capsulotomy

Optometrists are Albertans’ greatest defense against vision loss, especially in rural communities. The Alberta College of Optometrists (ACO) ensures Doctors of Optometry can offer the highest levels of safe and competent eye care to all Albertans.

Advances in the education and training of Alberta optometrists have outpaced the current regulated scope of the profession. That’s why the ACO is requesting an update to our legislation that will authorize Doctors of Optometry to perform limited laser (e.g. to treat glaucoma) and superficial skin procedures (e.g. removal of skin tags).

Our scope expansion submission represents a sustainable and cost-effective way to limit and guard against vision impairment and loss, and to improve the delivery of health services to Albertans – particularly in rural areas.

  • Doctors of Optometry are highly trained and skilled. Optometrists have been providing these same limited laser and superficial skin procedures in other North American jurisdictions for over 40 years in a safe and skilled manner. This authorization has never been repealed or scaled back in any jurisdiction due to concerns over the quality of care provided by optometrists.
  • With their 4-year doctoral-level university education (following a BSc program), Doctors of Optometry have the knowledge, skills and competencies to provide these requested procedures safely and proficiently.
  • The Alberta College of Optometrists will mandate that all practitioners who provide these services complete a rigorous certification course including a final exam – just as we did for all previous optometric scope expansions. This is in our patients’ best interest and part of our obligation as a College to protect the public.
  • Doctors of Optometry work in more than 100 communities across Alberta. Our members ensure Albertans receive high-quality and accessible vision care services in their local community. This is especially important for rural and Indigenous populations.

Benefits of Scope Expansion

The threat of eye disease and permanent vision loss increases with age. Albertans will require better access to skilled and competent eye care providers in the coming decades. Doctors of Optometry are the most accessible and affordable providers of this care. Optometrists authorized to diagnose and treat a greater range of conditions are essential to the future planning of Alberta’s health system, ensuring the provision of evidence-based, outcome-focused, cost-effective and timely health care.

Specifically, benefits of the proposed scope expansion include:

  • Greater access to vision care services in all areas of the province. This is especially important to rural, remote and Indigenous populations.
  • Improved health outcomes.
  • Reduced government payments for glaucoma medications for seniors.
  • Reduced pressure on family physicians and walk-in clinics by diverting patients who require vision care services to optometrists who are trained and technologically equipped to diagnose and treat eye disorders, diseases and injuries.
  • Reduced pressure on emergency departments.
  • Assurance that only those who have successfully completed a rigorous certification course/final exam or a program of study accepted by the College would be authorized to provide any of the proposed new activities.
  • This proposal is aligned with the Health Minister’s mandate from the Premier to address rural health challenges by leveraging the scope of allied health professionals.

Optometrist Training

Advances in the education and training of Alberta optometrists have outpaced their existing scope of practice. Doctors of Optometry are educated and clinically trained to practice at a higher level than legislated.

Updating the Health Professions Restricted Activity Regulation (HPRAR) (formerly the Optometrists Profession Regulation) to maintain a closer pace with modern education and clinical training offers more efficient care to Albertans, improved health outcomes, reduced costs to the government and continued protection of the public interest.

Adding scope also enhances the benefit of private-sector optometry clinics offering new services in urban and rural settings outside of Alberta Health Services facilities.

  • Doctors of Optometry receive 7-8 years of training followed by an optional, one-year post-graduate residency in a variety of subspecialties.
  • Students also complete clerkship placements under the direct supervision of a Doctor of Optometry or ophthalmologist, outside of the university optometry clinic.
  • The College will mandate that all currently registered Doctors of Optometry who wish to provide any newly authorized activity participate in and successfully complete a rigorous, validated certification course and final exam.
  • No “grandfathering” of any Regulated Member will occur. Newly graduated applicants to the ACO will have completed the Advanced Procedures certification course syllabus during their optometry program and must successfully pass the Optometry Examining Board of Canada Exam before a Practice Permit is issued.

Advanced Procedures certification courses:

  • Created, accredited, and administered by accredited universities. The University of Waterloo School of Optometry and Vision Science, the Northeastern State University Oklahoma College of Optometry and other similarly accredited programs offer these post-graduate certification courses.
  • Taught by certified ophthalmologists and optometrists.
  • Augment what students and practitioners have learned during their professional degree program, clerkship placements, previous Advanced Scope certification courses and previously completed Continuing Education courses/wetlabs.
  • Refresh clinical knowledge and skill sets while updating the Doctor of Optometry on new best practice modalities and protocols for treating any potential complications following the provision of these procedures.

The current 32.5-hour Advanced Procedures certification course content is split between injections, minor surgical and laser modules. It incorporates both didactic lectures and hands-on clinical wet labs with an emphasis on the hands-on components.

Improved Access to Optometrists in Rural Alberta

A survey was conducted by One Persuasion from February 23-25, 2022, on behalf of the Alberta College of Optometrists. 754 adults were surveyed, with a margin of error +/- 3.6%, 19 times out of 20. Findings include:

  • 63% of rural residents agree that their communities should have better access to eye care services than they do today.
  • At all education and income levels, at least 65% of Albertans agree that rural communities should have better access to eye care services than they do today.
  • 22% of rural Albertans have experienced delays in accessing eye care services.
    • Men and women between the ages of 18 and 34, across the province, have experienced the most delays accessing eye care services (M: 35%, W: 25%).
  • Rural Albertans travel the furthest to receive eye care (20% travel 50-250 km).